2010

February 23, 2010Feb 23, 2010

Originally published in MedPage Today by John Gever, MedPage Today Senior Editor Tube-feeding patients with advanced dementia -- a practice whose effectiveness has been questioned by two widely cited literature reviews -- is most common in larger hospitals and those…

Originally published in MedPage Today

by John Gever, MedPage Today Senior Editor

Tube-feeding patients with advanced dementia — a practice whose effectiveness has been questioned by two widely cited literature reviews — is most common in larger hospitals and those run for profit, researchers said.

The odds of a feeding-tube insertion in a hospitalized patient with advanced dementia were about 50% greater …

Physician voices

How the ER is now used to triage every patient

John Schumann, MD

February 22, 2010Feb 22, 201017

The ER is the portal of entry to our hospitals now, for better and for worse. On the plus side, this means that most patients being admitted to general medical and surgical services have a workup at least started and…

The ER is the portal of entry to our hospitals now, for better and for worse.

On the plus side, this means that most patients being admitted to general medical and surgical services have a workup at least started and are triaged appropriately to their destination.

A good ER evaluation should answer the following questions:

1. What’s the nature of the illness?

Are we dealing with the heart, the brain, or an abdominal organ? …

Conditions and diseases

What doctors do when they don’t know the answer

Alex Lickerman, MD

February 22, 2010Feb 22, 201010

Part two of a series. See also part one. Previously I’d discussed how most of the time diagnoses are relatively straightforward. But what do doctors do when a diagnosis isn’t immediately clear to them? Likely one or more of the…

Part two of a series. See also part one.

Previously I’d discussed how most of the time diagnoses are relatively straightforward. But what do doctors do when a diagnosis isn’t immediately clear to them?

Likely one or more of the following:

1. Revert to “novice” thinking. Which, in fact, is completely appropriate. We’re taught in medical school that approximately 90% of all diagnoses are made from the history, so if we can’t …

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Patient voices

End-of-life decisions and making advance directive choices

MedPage Today

February 22, 2010Feb 22, 20102

Originally published in MedPage Today by Crystal Phend "I do not want my life to be prolonged if, to a reasonable degree of medical certainty, my situation is hopeless." "I want my life to be prolonged as long as possible…

Originally published in MedPage Today

by Crystal Phend

“I do not want my life to be prolonged if, to a reasonable degree of medical certainty, my situation is hopeless.”

“I want my life to be prolonged as long as possible within the limits of generally accepted medical standards, even if this means that I might be kept alive on machines for years.”

Check …

Medical education

Forcing residents to nap may not improve patient care

MedPage Today

February 21, 2010Feb 21, 20106

Originally published in MedPage Today by Emily P. Walker, MedPage Today Washington Correspondent More that a year after the Institute of Medicine (IOM) issued a report calling for mandatory naps for medical residents, the organization responsible for implementing -- or…

Originally published in MedPage Today

by Emily P. Walker, MedPage Today Washington Correspondent

More that a year after the Institute of Medicine (IOM) issued a report calling for mandatory naps for medical residents, the organization responsible for implementing — or rejecting — the IOM’s controversial recommendation has yet to make a decision.

The Accreditation Council for Graduate Medical Education (ACGME), which has …

Health policy

Op-ed: Health reform requires listening to doctors

Kevin Pho, MD

February 21, 2010Feb 21, 20107

The following op-ed was published on January 29th, 2010 in The New York Times’ Room for Debate blog. With health reform’s future in peril, President Obama noted in his State of the Union address that the process has “left most…

The following op-ed was published on January 29th, 2010 in The New York Times’ Room for Debate blog.

With health reform’s future in peril, President Obama noted in his State of the Union address that the process has “left most Americans wondering what’s in it for them.”

For reform to succeed, the problems facing most patients today, ranging from their deteriorating relationship with doctors to the consequences of medical malpractice, have …

Health policy

Does your cardiologist deserve his salary?

John Mandrola, MD

February 20, 2010Feb 20, 201035

Conflicted am I on reading of the strategy of a group of South Miami cardiologists who have written their patients complaining of the cuts to reimbursement, primarily cuts in imaging procedures. A tension emerges from within upon reading the following…

“I’m not at all sympathetic with the cardiologists,” said Robert Berenson, a doctor who was once in charge of Medicare payment policy and now is a …

Health policy

Why Medicare and health care should be deregulated

David Allen, MD

February 20, 2010Feb 20, 201044

Should health care be controlled or provided by the government? I believe that years of answering 'yes' to this question has been at the root of most of the problems in the American health care system. Let's explore a few…

Should health care be controlled or provided by the government?

I believe that years of answering ‘yes’ to this question has been at the root of most of the problems in the American health care system. Let’s explore a few of these ‘yes’ answers:

Health care for the elderly must be provided by the government. By creating Medicare, the US government has massively and deleteriously affected medicine. The immediate effect …

Drugs and prescribing

Medical marijuana has doctors asking questions

Kevin

February 19, 2010Feb 19, 20108

Originally published in HCPLive.com In January, New Jersey became the 14th state in the nation to legalize marijuana use for certain chronic illnesses. Other states where the use of medical marijuana is permitted include Alaska, California, Colorado, Hawaii, Maine, Michigan,…

Originally published in HCPLive.com

In January, New Jersey became the 14th state in the nation to legalize marijuana use for certain chronic illnesses. Other states where the use of medical marijuana is permitted include Alaska, California, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Oregon, Rhode Island, Vermont, and Washington; around a dozen more states are weighing pending bills.

The New Jersey …

Physician voices

Laparoscopic procedures injure the surgeons that perform them

MedPage Today

February 19, 2010Feb 19, 2010

Originally published in MedPage Today by John Gever, MedPage Today Senior Editor Four out of five surgeons agree: Laparoscopic procedures cause substantial discomfort and pain for the surgeons who perform them. More than 80% of surgeons completing an online questionnaire…

Originally published in MedPage Today

by John Gever, MedPage Today Senior Editor

Four out of five surgeons agree: Laparoscopic procedures cause substantial discomfort and pain for the surgeons who perform them.

More than 80% of surgeons completing an online questionnaire reported pain or stiffness in the hands, neck, back, or legs after performing minimally invasive surgeries, according to Adrian Park, MD, of the …

Medical education

ACP: Resident work hours – Managing a precarious balance

American College of Physicians

February 18, 2010Feb 18, 201013

The following is part of a series of original guest columns by the American College of Physicians. by Steven Weinberger, MD, FACP In December 2008 the Institute of Medicine (IOM) released its report entitled “Resident Duty Hours: Enhancing Sleep, Supervision,…

The following is part of a series of original guest columns by the American College of Physicians.

by Steven Weinberger, MD, FACP

In December 2008 the Institute of Medicine (IOM) released its report entitled “Resident Duty Hours: Enhancing Sleep, Supervision, and Safety,” in which it proposed a number of changes to the current regulations developed and enforced by the Accreditation Council for Graduate Medical Education (ACGME).

Since the time …

Physician voices

Texting and cell phone use are becoming more common in hospitals

Edwin Leap, MD

February 18, 2010Feb 18, 20109

The cell-phone is a wonderful device. Even I, somewhat Luddite about certain technologies, find it delightfully useful for things like calling my wife when I lose the grocery list, calling my wife for directions and calling my wife to remind me of what I was supposed to be doing. I’m not really a fan of texting, though my wife and oldest son seem to communicate that way quite effectively. It’s …

Conditions and diseases

Treating ADHD may not improve kids’ school grades

MedPage Today

February 18, 2010Feb 18, 20103

Originally published in MedPage Today by Kristina Fiore, MedPage Today Staff Writer Adhering to guidelines when treating children with attention deficit hyperactivity disorder (ADHD) relieved symptoms but had no effect on kids' performance in school or in their relationships with…

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Adhering to guidelines when treating children with attention deficit hyperactivity disorder (ADHD) relieved symptoms but had no effect on kids’ performance in school or in their relationships with others, researchers found.

Although parents and teachers noted significant improvements in symptoms among ADHD kids (P<0.001) in a special treatment program, there …

HIMSS 2010 Better Health social media coverage

Kevin

February 18, 2010Feb 18, 2010

This year, the Better Health team will be offering live coverage of healthcare’s largest tech conference: HIMSS in Atlanta, March 1-4. Three medical bloggers, Dr. Val Jones, Dr. Mike Sevilla, and Dr. Nick Genes will interview over 40 different exhibitors…

This year, the Better Health team will be offering live coverage of healthcare’s largest tech conference: HIMSS in Atlanta, March 1-4.

Three medical bloggers, Dr. Val Jones, Dr. Mike Sevilla, and Dr. Nick Genes will interview over 40 different exhibitors and stream their interviews live via UStream.

You can ask questions of the interviewees by submitting questions to @drval during …

Conditions and diseases

Treating atrial fibrillation with catheter ablation on TV may not be ethical

Larry Husten, PhD

February 17, 2010Feb 17, 20104

Mauricio Arruda performed a live atrial fibrillation ablation at University Hospitals in Cleveland on the Today Show recently. The 6-minute segment was relentlessly upbeat. The TV producers pulled every trick in the book to overcome the inherent difficulty of portraying…

Mauricio Arruda performed a live atrial fibrillation ablation at University Hospitals in Cleveland on the Today Show recently.

The 6-minute segment was relentlessly upbeat. The TV producers pulled every trick in the book to overcome the inherent difficulty of portraying a hard-to-explain disease like atrial fibrillation and an even harder-to-explain procedure like catheter ablation. Instead of making any effort to truly educate their viewers, the producers took the easy …

Conditions and diseases

Magnetic resonance imaging (fMRI) for persistent vegetative state

MedPage Today

February 17, 2010Feb 17, 2010

Originally published in MedPage Today by Michael Smith, MedPage Today North American Correspondent Researchers in England are reporting they have been able to establish limited communication with a man in a persistent vegetative state by using functional magnetic resonance imaging…

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

Researchers in England are reporting they have been able to establish limited communication with a man in a persistent vegetative state by using functional magnetic resonance imaging (fMRI).

The 34-year-old man was able to answer simple Yes or No questions by imagining different types of activity, which caused changes …

Conditions and diseases

Don’t fall into the dementia trap when treating a developmental disability

Lockup Doc, MD

February 16, 2010Feb 16, 20105

by Lockup Doc In addition to correctional psychiatry, I spend about half of my professional time treating patients with developmental and intellectual disabilities (mental retardation). The majority of my patients have severe or profound mental retardation and are completely nonverbal.…

by Lockup Doc

In addition to correctional psychiatry, I spend about half of my professional time treating patients with developmental and intellectual disabilities (mental retardation). The majority of my patients have severe or profound mental retardation and are completely nonverbal.

Over the years I have observed that when many of them are admitted to the hospital for acute medical or surgical problems, because they are severely cognitively and functionally impaired, they are …

Patient voices

How to better notify patients of their abnormal test results

Shantanu Nundy, MD

February 16, 2010Feb 16, 201010

I just returned from vacation to find email messages from three patients inquiring about their recent test results. The first email was from a young man who had fainted and underwent Holter monitoring, a test that checks for abnormal heart…

I just returned from vacation to find email messages from three patients inquiring about their recent test results.

The first email was from a young man who had fainted and underwent Holter monitoring, a test that checks for abnormal heart rhythms. The second was from a woman I recently started on cholesterol-modifying therapy who wanted to know whether her recent blood work showed a satisfactory improvement in her cholesterol. The third …

Health policy

Why is President Obama ignoring the doctors when it comes to health reform?

Ernesto Gutierrez, MD

February 15, 2010Feb 15, 201017

There is a lot of discussion about what Obama did right and wrong in managing the politics of passing health insurance reform. What strikes me as the most obvious is the failure to engage physicians. Sure there was support from the AMA, ACP, and AAFP, but the support was lukewarm at best. The position letters sent out to society members outlining their support seemed forced and mandatory. Physicians …

Conditions and diseases

Why The Biggest Loser uses CT scans to help contestants lose weight

MedPage Today

February 15, 2010Feb 15, 20103

Originally published in MedPage Today by Cole Petrochko The train wreck has become an integral part of reality TV programming, and that's terrible. As much as I've learned on the internet about the "Snooki Punch" fiasco from MTV's Jersey Shore,…

Originally published in MedPage Today

by Cole Petrochko

The train wreck has become an integral part of reality TV programming, and that’s terrible. As much as I’ve learned on the internet about the “Snooki Punch” fiasco from MTV’s Jersey Shore, there’s little to watching a household of adults thrown together under a wacky premise turn into overgrown, throat-seeking children under lights and a camera, except on the one-season CBS show Kid …

2010

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